title: A prospective study of faecal calprotectin and lactoferrin in the monitoring of acute radiation proctitis in prostate cancer treatment.
abstract: OBJECTIVE
  Acute radiation proctitis is a relevant complication of pelvic radiation. The purpose of this study was to investigate two markers of gut inflammation as non-invasive diagnostic tools to evaluate acute radiation proctitis.
  
  
  METHODS
  Twenty patients who underwent radiotherapy for prostate cancer took part in this prospective study. Radiation-induced toxicity was evaluated weekly during radiotherapy in compliance with the CTC toxicity criteria. Stool samples from patients were examined before treatment, weekly during radiotherapy and 2 weeks after the end of radiotherapy using enzyme-linked immunosorbent assay for calprotectin and lactoferrin and correlated with the CTC toxicity.
  
  
  RESULTS
  Calprotectin and lactoferrin faecal values increased significantly during radiation treatment and decreased about 2 weeks after cessation of radiation. Faecal concentrations of calprotectin and lactoferrin correlated with the documented radiation proctitis symptoms (all grades together) in 15/20 patients (75%). With respect to changes in faecal concentrations and correspondence to proctitis symptoms, both markers showed parallel results in 90% of the patients. On comparing calprotectin and lactoferrin concentrations between the 4th week of radiation and the 1st week, it was found that patients with any grade of toxicity exhibited a significantly higher increase in calprotectin (p = 0.044) and lactoferrin (p = 0.05), respectively, compared with those without toxicity.
  
  
  CONCLUSIONS
  Calprotectin and lactoferrin faecal values changed during radiation treatment and after cessation of radiation, with correlation to acute proctitis symptoms in most of the patients. Before markers are used to monitor acute radiation proctitis, further experience should be acquired. Patients will be followed to determine the predictive value of the two tested markers for chronic radiation proctitis.
authors.affiliation: Department of Radiotherapy and Radio-oncology, University of Göttingen, Göttingen, Germany. ahille@med.uni-goettingen.de
authors.forename: Andrea
authors.initials: A
authors.lastname: Hille
authors.forename: Emine
authors.initials: E
authors.lastname: Schmidt-Giese
authors.forename: Robert M
authors.initials: RM
authors.lastname: Hermann
authors.forename: Markus K A
authors.initials: MK
authors.lastname: Herrmann
authors.forename: Margret
authors.initials: M
authors.lastname: Rave-Fränk
authors.forename: Markus
authors.initials: M
authors.lastname: Schirmer
authors.forename: Hans
authors.initials: H
authors.lastname: Christiansen
authors.forename: Clemens F
authors.initials: CF
authors.lastname: Hess
authors.forename: Giuliano
authors.initials: G
authors.lastname: Ramadori
mesh_terms: D000208:Acute Disease; D015415:Biomarkers / Q000032:analysis*; D004797:Enzyme-Linked Immunosorbent Assay; D005243:Feces / Q000737:chemistry*; D006801:Humans; D007781:Lactoferrin / Q000032:analysis*; D039841:Leukocyte L1 Antigen Complex / Q000032:analysis*; D008297:Male; D008991:Monitoring, Physiologic; D011349:Proctitis / Q000175:diagnosis*; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000175:diagnosis*
chemical_list: D015415:Biomarkers; D039841:Leukocyte L1 Antigen Complex; D007781:Lactoferrin